Shading sign of endometrioma

Case contributed by Prashant Gupta


Menstrual disturbance for one month.

Patient Data

Age: 50 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.


T1 hyperintense cyst in the right ovary. T1 fat saturation showing that the hyperintensity is not fat but hemorrhage. T2 shading sign. In the sagittal plane, there is a large left ovarian cyst as well. A tortuous tubular hyperintensity is seen in the right adnexa, likely a hematosalpinx.

Case Discussion

Shading sign is the magnetic resonance (MR) imaging finding of T2 shortening in an adnexal cyst that is hyperintense on T1-weighted images. It is helpful as a distinguishing feature of endometriotic cysts (endometriomas) on MR imaging.

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